NPI | 1699067926 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD470261) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207L00000X Anesthesiology (Licence: FL ME123241) | |
Enumeration Date | 2011-05-04 |
Last Update Date | 2022-01-20 |