| NPI | 1700172020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 65239-20) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125060369) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2021-04-01 |