| NPI | 1255834032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301509827) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125072420) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-17 |
| Last Update Date | 2023-07-24 |