NPI | 1124317862 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME141557) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: PR 18866) |
207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 63641) | |
207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME141557) | |
Enumeration Date | 2011-04-04 |
Last Update Date | 2021-04-12 |