| NPI | 1376773150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MO 2014004831) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: KS 0437019) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036.140280) | |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2017-01-05 |