| NPI | 1174964951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD D91124) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA MD-50213) |
| 208600000X Surgery (Licence: IL 036161994) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IA MD-50213) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036161994) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: IA MD-50213) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: IL 036161994) | |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2025-02-10 |