| NPI | 1760878177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 68565-20) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: IL 036171225) |
| 208000000X Pediatrics (Licence: WI 68565-20) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2025-01-07 |