| NPI | 1992123269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: WI 7441020) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036-146109) |
| 207L00000X Anesthesiology (Licence: IL 125065785) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: IL 036.146109) | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2022-02-07 |