| NPI | 1043883697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 125077648) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125077648) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125077648) | |
| Enumeration Date | 2021-07-21 |
| Last Update Date | 2023-06-21 |