| NPI | 1174789846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N6853) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036-121146) |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2020-04-30 |