| NPI | 1407887722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: SC 40374) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: MO 2008013256) |
| 208600000X Surgery (Licence: IN 01030012) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: VT 042-0008206) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2019-11-26 |