| NPI | 1417936600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MN 32081) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: MN 32081) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2022-03-31 |