NPI | 1508814146 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: PA MD068661L) |
Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: NJ 25MA07298100) |
Enumeration Date | 2006-05-05 |
Last Update Date | 2017-02-07 |