| NPI | 1750361242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 200000806) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: NC 200000806) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2022-01-26 |