| NPI | 1902033921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P6105) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125-056807) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2014-04-15 |