| NPI | 1467523340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: WA MD00041351) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: CA A62693) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2022-12-19 |