| NPI | 1851421705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TN 61934) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2008032789) |
| 208600000X Surgery (Licence: IL 036131427) | |
| 208600000X Surgery (Licence: RI MD11328) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2024-10-01 |