| NPI | 1639280480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: UT 6197043-1205) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: UT 6197043-1205) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2013-11-26 |