| NPI | 1619139888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT 12405) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125-051824) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2022-11-03 |