| NPI | 1699528711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 125.085626) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.085626) |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2026-06-24 |