| NPI | 1902112840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 036.125690) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036125690) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2021-12-20 |