| NPI | 1720078454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME75977) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036096985) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036096985) | |
| 207Q00000X Family Medicine (Licence: IL 036096985) | |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2017-07-21 |