| NPI | 1164747390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NV 22915) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A170786) |
| 208600000X Surgery (Licence: IL 036158638) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: GA 73167) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2021042920) | |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2022-12-16 |