| NPI | 1811089600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036124722) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 32026) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 32026) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2021-06-24 |