| NPI | 1508968884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: LA MD.11549R) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA MD.11549R) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA 11549R) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2017-12-05 |