| NPI | 1396956116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35.094432) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.094432) |
| 208600000X Surgery (Licence: LA MD.201800) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: LA MD.201800) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2024-01-05 |