NPI | 1487817581 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: WA MD60018366) |
Additional Taxonomies | 208600000X Surgery (Licence: WA MD60018366) |
Enumeration Date | 2008-07-08 |
Last Update Date | 2009-02-18 |