NPI | 1174843841 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: PA MD456999) |
Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MT197252) |
207L00000X Anesthesiology (Licence: PA MD456999) | |
207L00000X Anesthesiology (Licence: SC 81755) | |
207L00000X Anesthesiology (Licence: MI 4301098878) | |
Enumeration Date | 2010-06-04 |
Last Update Date | 2021-02-03 |