| NPI | 1780667683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 30724-20) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036124777) |
| 207L00000X Anesthesiology (Licence: WI 37204-020) | |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2015-06-22 |