| NPI | 1538336367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: TX P3391) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX p3391) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2024-09-03 |