| NPI | 1245296292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD042146L) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: PA MD042146L) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2009-10-07 |