NPI | 1154340404 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: SC 29155) |
Additional Taxonomies | 208000000X Pediatrics (Licence: SC 29155) |
2086S0102X Surgery, Surgical Critical Care (Licence: SC 29155) | |
Enumeration Date | 2006-07-18 |
Last Update Date | 2021-05-14 |