| NPI | 1346660875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101279414) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: TX T5097) |
| 208600000X Surgery (Licence: TX T5097) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101279414) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: VA 0101279414) | |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2023-10-15 |