| NPI | 1548581226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036132595) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125054403) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: IL 036132595) | |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2018-10-30 |