| NPI | 1134296577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OK 28432) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 117899) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MO 117899) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2017-07-27 |