| NPI | 1356620371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 036.138308) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301099229) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125060759) | |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2024-02-16 |