| NPI | 1609166776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NY 268076-01) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036-140884) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2019-11-15 |