NPI | 1205916632 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35.131998) |
Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: OK 30557) |
2086S0120X Surgery, Pediatric Surgery (Licence: IN 01079052A) | |
2086S0120X Surgery, Pediatric Surgery (Licence: TX L2175) | |
Enumeration Date | 2006-10-17 |
Last Update Date | 2019-05-28 |