| NPI | 1215431317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0069667) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: OK 9546) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2026-05-05 |