| NPI | 1356583413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036.130998) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036.130998) |
| 2086S0127X Surgery, Trauma Surgery (Licence: IL 036.130998) | |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2020-01-31 |