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Individual

MAKSIM PERGAMENSHCHIKOV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BA

Contact information

Practice address
27 SALVATORE DR, NOVATO, CA 94949-6015
(415) 761-0436
Mailing address
27 SALVATORE DR, NOVATO, CA 94949-6015

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Enumeration date
04/05/2021
Last updated
04/05/2021
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