| NPI | 1316143563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: ME MD23637) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: MO 2020012131) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: IN 01067306A) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MN 45654) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: AK 7937) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: KY 42783) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35.093326) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: IA 41986) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2020-05-28 |