NPI | 1235176439 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: FL ME138873) |
Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: MA 216139) |
Enumeration Date | 2006-05-31 |
Last Update Date | 2022-02-16 |