| NPI | 1558546788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AK 6550) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: TN 43121) |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2019-09-24 |