NPI | 1730163007 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M5187) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME0046722) |
207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME46722) | |
Enumeration Date | 2005-12-01 |
Last Update Date | 2025-06-24 |