NPI | 1295726024 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CO 27439) |
Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: NY 250878) |
Enumeration Date | 2005-11-01 |
Last Update Date | 2023-02-08 |