| NPI | 1144322561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: NJ 25MA08821500) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: CA C169195) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: NY 253600) | |
| 208600000X Surgery (Licence: NJ 25MA08821500) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: FL ME136023) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2021-07-23 |