| NPI | 1265099139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MA 295172) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125074023) |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2022-09-12 |