| NPI | 1477965739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: OH 35C.001010) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036161896) |
| 2086S0102X Surgery Surgical Critical Care (Licence: WI 3028) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: IN 01091857A) | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2025-06-20 |