| NPI | 1285865527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MO 2017033337) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036.132825) |
| 208600000X Surgery (Licence: MO 2017033337) | |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2023-09-19 |