| NPI | 1720036007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: LA MD.011606) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: LA L011606) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2017-01-19 |