| NPI | 1306860663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: NY 234-277) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA08088300) |
| 208600000X Surgery (Licence: NY 234-277) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: NJ 25MA08088300) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-03-07 |