NPI | 1508395690 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 91421) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 91421) |
207LP2900X Anesthesiology, Pain Medicine (Licence: MA 287445) | |
207R00000X Internal Medicine (Licence: MA 271963) | |
207L00000X Anesthesiology (Licence: MA 271963) | |
207L00000X Anesthesiology (Licence: MA 287445) | |
Enumeration Date | 2017-06-12 |
Last Update Date | 2024-02-01 |