| NPI | 1912448119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 036166962) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 292383) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2024-09-30 |