| NPI | 1013004670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036-128374) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: CO 41777) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: ND PT13390) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2021-04-05 |