NPI | 1205808490 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MN 43768) |
Additional Taxonomies | 208600000X Surgery (Licence: IA 41264) |
208600000X Surgery (Licence: MN 43768) | |
2086S0120X Surgery, Pediatric Surgery (Licence: IA 41264) | |
Enumeration Date | 2006-02-02 |
Last Update Date | 2020-08-19 |