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 |