| NPI | 1144206749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NC 9701110) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: NC 9701110) |
| 2086S0129X (Licence: NC 9701110) | |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2010-11-12 |