NPI | 1184873820 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OR MD222471) |
Additional Taxonomies | 208600000X Surgery (Licence: NY P56024) |
2086S0120X Surgery, Pediatric Surgery (Licence: OK 28356) | |
Enumeration Date | 2008-09-18 |
Last Update Date | 2025-02-24 |