NPI | 1194882175 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CO 50786) |
Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35.083881) |
Enumeration Date | 2007-01-02 |
Last Update Date | 2022-11-14 |