| NPI | 1083000319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: WI 66250) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 66250) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: IL 036.148780) | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2020-10-19 |