NPI | 1336527548 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME129050) |
Additional Taxonomies | 171000000X Military Health Care Provider |
207L00000X Anesthesiology (Licence: FL ME129050) | |
Enumeration Date | 2015-05-08 |
Last Update Date | 2024-05-09 |