NPI | 1821677881 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: TX U6538) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0076319) |
Enumeration Date | 2021-04-06 |
Last Update Date | 2025-09-30 |