| NPI | 1588669303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M4849) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 036-111921) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX M4849) | |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2024-03-22 |