| NPI | 1487725206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CA A62576) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: NM MD2015-0029) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: WA MD60385007) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: CA A82578) | |
| 174400000X Specialist (Licence: CA A82578) | |
| 208600000X Surgery (Licence: CA A62576) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2024-04-29 |