| NPI | 1447330410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: ME MD18028) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: AK 5423) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2014-11-26 |