| NPI | 1447452057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2026-00671) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036142984) |
| 208600000X Surgery (Licence: UT 14183540-1235) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036142984) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301089918) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: SC 89247) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2026-03-10 |