| NPI | 1962633164 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: GA 66438) | 
| Additional Taxonomies | 207VC0200X Obstetrics & Gynecology, Critical Care Medicine (Licence: MI 4301095126) | 
| 207VC0200X Obstetrics & Gynecology, Critical Care Medicine (Licence: GA 66438) | |
| 207VC0200X Obstetrics & Gynecology, Critical Care Medicine (Licence: HI 17335) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: HI 17335) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CA A131300) | |
| 207VC0200X Obstetrics & Gynecology, Critical Care Medicine (Licence: CA A131300) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301095126) | |
| 208M00000X Hospitalist (Licence: OR MD190651) | |
| Enumeration Date | 2009-08-05 | 
| Last Update Date | 2019-01-03 |