NPI | 1902250814 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036165288) |
Additional Taxonomies | 208600000X Surgery (Licence: CA 1902250814) |
Enumeration Date | 2016-04-17 |
Last Update Date | 2023-07-20 |