| NPI | 1659951382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61652753) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.079252) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2025-12-02 |