| NPI | 1255853792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: WA MD.MD.70083028) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036167108) |
| 208600000X Surgery (Licence: WA MD.MD.70083028) | |
| Enumeration Date | 2017-07-15 |
| Last Update Date | 2026-04-09 |