NPI | 1841812237 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 125-078312) |
Additional Taxonomies | 171000000X Military Health Care Provider |
Enumeration Date | 2020-05-08 |
Last Update Date | 2021-06-24 |