| NPI | 1083604821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: IL 036160346) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: OH 35132228) |
| 208600000X Surgery (Licence: OH 35132228) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2023-01-31 |