| NPI | 1518953538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: TX U0050) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036-104705) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2023-03-28 |