| NPI | 1881222735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 13882325-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.076470) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 13882325-1204) | |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2024-05-23 |