| NPI | 1477916740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61165842) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.069821) |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2021-08-07 |