| NPI | 1568598332 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35.098045) | 
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.098045) | 
| 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35.098045) | |
| Enumeration Date | 2007-02-26 | 
| Last Update Date | 2023-01-11 |