| NPI | 1124280052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 54185) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125-051421) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2025-07-10 |