| NPI | 1487912721 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 036170016) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 76210) |
| 207L00000X Anesthesiology (Licence: CA C193443) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2025-01-31 |