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 |