| NPI | 1003045097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME152670) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME152670) |
| 208600000X Surgery (Licence: TN 52389) | |
| 208600000X Surgery (Licence: IL 036-143764) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036-143764) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TN 52389) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: GA 87843) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: IL 036-143764) | |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2025-08-19 |