| NPI | 1417404211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 125.077670) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL B34272494028) |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2021-10-14 |