| NPI | 1588911077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 265773) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125061400) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: IL 125061400) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 125061400) | |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2016-06-08 |