| NPI | 1386600898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: NY 264936) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036-121483) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2012-08-31 |