| NPI | 1487862652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036.122305) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036.122305) |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2016-01-27 |