NPI | 1154522308 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V6509) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57012275) |
Enumeration Date | 2007-05-29 |
Last Update Date | 2025-08-14 |