NPI | 1760720171 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 010124417) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0079337) |
207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MD D0079337) | |
Enumeration Date | 2013-01-18 |
Last Update Date | 2025-07-28 |