NPI | 1225495831 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101262884) |
Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 01012628844) |
Enumeration Date | 2016-01-27 |
Last Update Date | 2023-06-30 |