| NPI | 1700836046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MO 117590) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: KS 04-27932) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2024-02-19 |