| NPI | 1326364654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MO 2012003519) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2012003519) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2012003519) | |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2015-10-23 |