| NPI | 1508214065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.137494) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125069843) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2020-08-13 |