| NPI | 1184695520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036-121923) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 46894) |
| 208600000X Surgery (Licence: IL 036.121923) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2024-01-29 |