| NPI | 1831290691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 32193) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 32193) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2012-04-25 |