| NPI | 1992966592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: IL 036158123) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301085694) |
| 208600000X Surgery (Licence: CA A99192) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301085694) | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2022-01-12 |