| NPI | 1568615995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD464007) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036.127648) |
| 207R00000X Internal Medicine (Licence: IL 036.127648) | |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2018-05-25 |