| NPI | 1104892389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 36082006) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: IL 36082006) |
| 2086S0127X Surgery, Trauma Surgery (Licence: IL 36082006) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2011-08-25 |