| NPI | 1275741076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: NC 2009-00994) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: AR E-5149) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2010-07-29 |