NPI | 1295818789 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MN 35817) |
Additional Taxonomies | 208600000X Surgery (Licence: MN 35817) |
Enumeration Date | 2006-10-20 |
Last Update Date | 2012-05-14 |