| NPI | 1093138075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD468986) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125067754) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2020-02-12 |