| NPI | 1295024370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CO DR.0058888) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125059546) |
| 208600000X Surgery (Licence: CO DR.0058888) | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2017-07-24 |