| NPI | 1558471441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX P0877) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA ML20008384) |
| 207R00000X Internal Medicine (Licence: WA ML00048672) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2014-08-13 |