| NPI | 1801138425 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 67210)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125064338)  | 
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CT 67210)  | |
| Enumeration Date | 2013-03-21 | 
| Last Update Date | 2021-06-17 |