| NPI | 1417973926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AR C-8200) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: TX K5152) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: AR C-8200) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2026-07-15 |