| NPI | 1134107956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: PA MD027246E) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: VA 0101046226) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MD 41229) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: TN 72094) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2024-08-15 |