| NPI | 1053773747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME144054) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.068183) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2020-06-27 |