| NPI | 1275157513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 125.084591) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95155716) |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2024-09-02 |