| NPI | 1881157360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: AL MD.48888) |
| Additional Taxonomies | 208600000X Surgery (Licence: ND PT22878) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2025-09-26 |