| NPI | 1184692360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: OK 16328) |
| Additional Taxonomies | 208600000X Surgery (Licence: OK 16328) |
| 2086S0102X Surgery Surgical Critical Care (Licence: OK 16328) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2014-09-05 |