NPI | 1053391227 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: SC 83998) |
Additional Taxonomies | 208600000X Surgery (Licence: VA 010123294) |
2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101232194) | |
2086S0120X Surgery, Pediatric Surgery (Licence: VA 0101232194) | |
Enumeration Date | 2006-01-21 |
Last Update Date | 2021-06-08 |