| NPI | 1205920220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2004034166) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-090872) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2004034166) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: MO 2004034166) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-03-07 |