NPI | 1861645624 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 50238) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D80375) |
207L00000X Anesthesiology (Licence: NE 25332) | |
207L00000X Anesthesiology (Licence: VA 0101259908) | |
Enumeration Date | 2008-10-24 |
Last Update Date | 2022-07-21 |