| NPI | 1649441619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036-115752) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036115752) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2021-04-30 |