| NPI | 1447230032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME160795) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: MI 4301086349) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2024-12-09 |