| NPI | 1306812029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 117216) |
| Additional Taxonomies | 208600000X Surgery (Licence: KS 30773) |
| 208600000X Surgery (Licence: IL 036157894) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036157894) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: IL 036157894) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: MO 117216) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2021-09-14 |