| NPI | 1992980783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35120787) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036171144) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036171144) | |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2025-08-18 |