| NPI | 1417961061 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 89895) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 36082615) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 36082615) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2025-01-17 |