| NPI | 1972535227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: WY 7144A) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036096773) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2016-12-27 |