| NPI | 1871563031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME85894) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: ID M-14497) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2023-12-08 |