| NPI | 1053335786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MD D61840) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D61840) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2019-09-19 |