NPI | 1134539471 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S4602) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125-065680) |
207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036148562) | |
Enumeration Date | 2014-05-07 |
Last Update Date | 2022-01-28 |