| NPI | 1376920538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2020012380) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036156617) |
| 208600000X Surgery (Licence: MO 2020012380) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY OS020702) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036156617) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: IL 036156617) | |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2023-01-25 |