| NPI | 1336644194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 05-46140) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.072121) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2022-06-28 |