| NPI | 1992764237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX H3707) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: TX H3707) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2013-07-31 |