| NPI | 1205035888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35096212) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301093139) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301093139) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MI 4301093139) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2022-08-24 |