| NPI | 1972752848 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA a90628)  | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA a90628)  | 
| Enumeration Date | 2008-09-15 | 
| Last Update Date | 2008-09-15 |