| NPI | 1356963219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61543068) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.075890) |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2024-08-29 |