| NPI | 1962452250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: VA 0101287006) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101287006) |
| 208600000X Surgery (Licence: VA 0101287006) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: GA 058399) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2025-11-17 |