| NPI | 1033406640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35.128379) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 58839) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: OK 35.128379) | |
| Enumeration Date | 2011-07-03 |
| Last Update Date | 2023-01-19 |