| NPI | 1891179644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD213814) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.067855) |
| 207L00000X Anesthesiology (Licence: KY 54039) | |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2023-07-06 |