| NPI | 1104817121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 036-122017) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.085509) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2023-09-08 |