| NPI | 1184899858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: AL MD.33382) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: ID M-13336) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2021-04-12 |