| NPI | 1184682213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: PA MD434491) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2010-00029) |
| 208600000X Surgery (Licence: PA MD434491) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2025-03-12 |