| NPI | 1912993155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A64227) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036159254) |
| 207L00000X Anesthesiology (Licence: WI 84637) | |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2024-09-23 |