NPI | 1194113712 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME144653) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35136353) |
207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME144653) | |
208D00000X General Practice (Licence: PR 13571-I) | |
Enumeration Date | 2015-01-05 |
Last Update Date | 2020-08-18 |