| NPI | 1588920516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD476668) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036143486) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036143486) | |
| 208VP0000X (Licence: IL 036143486) | |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2024-06-11 |