| NPI | 1902250814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA 1902250814) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036165288) |
| Enumeration Date | 2016-04-17 |
| Last Update Date | 2024-07-16 |