| NPI | 1649353624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101271302) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NJ 25MA06661300) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME0070480) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 15204L) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2021-08-03 |