| NPI | 1952831232 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: AZ 69506) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125071320) | 
| 208600000X Surgery (Licence: IL 125071320) | |
| Enumeration Date | 2017-06-19 | 
| Last Update Date | 2023-09-26 |