| NPI | 1891728887 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD046448L) | 
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD046448L) | 
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036144511) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: IL 036144511) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: MI EMC0002596) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA MD046448L) | |
| 208600000X Surgery (Licence: IL 036144511) | |
| 208600000X Surgery (Licence: ID MC-2223) | |
| Enumeration Date | 2006-07-10 | 
| Last Update Date | 2025-04-14 |