| NPI | 1134539471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 103451) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX S4602) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036148562) | |
| 207L00000X Anesthesiology (Licence: IL 125-065680) | |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2026-02-03 |