NPI | 1548241565 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME175802) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 155788) |
207L00000X Anesthesiology (Licence: NH 10444) | |
Enumeration Date | 2005-11-08 |
Last Update Date | 2025-08-29 |