| NPI | 1215996582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 036.131960) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS7770) |
| 207L00000X Anesthesiology (Licence: OH 34.006388) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2020-10-14 |