NPI | 1770141483 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD221198) |
Additional Taxonomies | 208600000X Surgery (Licence: SC LL82566) |
208D00000X General Practice (Licence: SC 82556) | |
Enumeration Date | 2019-05-29 |
Last Update Date | 2025-03-11 |