| NPI | 1023461506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 036155410) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 266879) |
| 207L00000X Anesthesiology (Licence: IA R-10818) | |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2021-06-11 |