| NPI | 1497783070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G64016) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: CA G64016) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2018-03-30 |