| NPI | 1275501231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: WV 19599) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: VA 0101240523) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: IN 01080418) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2022-11-03 |