| NPI | 1366132896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 125081683) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125081683) |
| Enumeration Date | 2023-05-09 |
| Last Update Date | 2023-05-22 |