| NPI | 1063665859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD442121) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: NJ 25MA09943300) |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2020-10-19 |