| NPI | 1437129046 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MT 9972) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: MI 4301058724) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2007-07-08 |