| NPI | 1629262571 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 036.123908) | 
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036.123908) | 
| Enumeration Date | 2007-09-04 | 
| Last Update Date | 2018-03-13 |