| NPI | 1184688756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036142403) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 44528) |
| 208600000X Surgery (Licence: IA 37731) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: IA 37731) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35.120176) | |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2023-10-12 |