| NPI | 1669899720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 10742194-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.064786) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2018-06-12 |