NPI | 1285610501 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: CA g72968) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX J4835) |
207L00000X Anesthesiology (Licence: AZ 75207) | |
Enumeration Date | 2005-12-19 |
Last Update Date | 2025-06-10 |