| NPI | 1235545070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2020014402) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036159639) |
| 207R00000X Internal Medicine (Licence: KS 94-08513) | |
| 207L00000X Anesthesiology (Licence: KS 94-08513) | |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2023-01-27 |