| NPI | 1083820716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: CA A70021) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A70021) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2018-01-26 |