| NPI | 1356459515 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G73101) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036094757) | 
| Enumeration Date | 2006-08-28 | 
| Last Update Date | 2017-02-03 |