| NPI | 1801854104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G43710) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA G43710) |
| 207R00000X Internal Medicine (Licence: CA G43710) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2007-07-08 |