| NPI | 1437372828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036146102) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: FL ME121030) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208600000X Surgery (Licence: IL 036146102) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036146102) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: OR PG163428) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2021-04-30 |