| NPI | 1467957399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 70277) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: IL 125.072492) | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2023-08-30 |