| NPI | 1821484601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: IL 036.166381) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036166381) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2026-02-06 |