NPI | 1548402969 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: FL ME150880) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2012-02149) |
207LC0200X Anesthesiology Critical Care Medicine (Licence: NC 2012-02149) | |
Enumeration Date | 2009-03-31 |
Last Update Date | 2021-07-16 |