| NPI | 1275709644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX Q5538) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: CA A91722) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: DC MD 037328) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: TX Q5538) | |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2015-09-22 |