| NPI | 1346218526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OK 15118) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: OK 15118) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2013-07-22 |