| NPI | 1447612502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2025033072) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036166188) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036166188) | |
| Enumeration Date | 2016-03-27 |
| Last Update Date | 2025-08-26 |