| NPI | 1447321203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CA G84775) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: NJ 25MA10889900) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: NY 199451) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2021-06-29 |