| NPI | 1336403864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: TX R4868) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125062283) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2018-03-12 |