| NPI | 1962441428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MO R7F58) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO R7F58) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2007-07-08 |