| NPI | 1912116997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME101262) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125-045422) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2013-10-03 |