| NPI | 1356970768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: NJ 25MA1161600) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: ZZ 7012097) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2022-09-14 |