| NPI | 1902337918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A202989) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.070042) |
| 207L00000X Anesthesiology (Licence: IL 036159282) | |
| 207R00000X Internal Medicine (Licence: IL 125070042) | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2025-08-06 |