| NPI | 1619437571 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-52688)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.073675)  | 
| Enumeration Date | 2019-03-25 | 
| Last Update Date | 2025-10-17 |