NPI | 1881215606 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME0167001) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207L00000X Anesthesiology (Licence: IL 125.075986) | |
Enumeration Date | 2020-05-04 |
Last Update Date | 2025-09-24 |