| NPI | 1275765380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME121542) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036-168467) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN 13838) | |
| Enumeration Date | 2009-08-23 |
| Last Update Date | 2024-07-02 |