| NPI | 1710273719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301110427) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MI 4301110427) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MI 4301110427) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2023-08-11 |