| NPI | 1710448378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME161514) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036176348) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2025-08-20 |