| NPI | 1801231592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S5131) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: IL 125063405) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2020-07-31 |