NPI | 1295928992 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: VA 0101237743) |
Additional Taxonomies | 208600000X Surgery (Licence: VA 0101237743) |
2086S0120X Surgery, Pediatric Surgery (Licence: PA MD460614) | |
Enumeration Date | 2007-08-26 |
Last Update Date | 2023-07-12 |