| NPI | 1740487545 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036133685) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA R8024) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2012015911) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-10-30 |