| NPI | 1902579436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 82694) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.080410) |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2026-06-22 |