| NPI | 1003131798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34.011138) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036131378) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2023-05-16 |