| NPI | 1528011293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CO 30895) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CO 30895) |
| 2086S0127X Surgery, Trauma Surgery (Licence: CO 30895) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2021-03-25 |