| NPI | 1780613695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 35778) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036-168010) |
| 207L00000X Anesthesiology (Licence: NJ 25IA12586100) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 35778) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2025-04-09 |