| NPI | 1215256441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: LA 340073) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: MS 25089) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: VA 0101268479) | |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2024-03-18 |