| NPI | 1790134120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: IL 036.166525) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: IL 036-166525) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036-166525) | |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2023-12-01 |