| NPI | 1528024783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: FL ME111827) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: LA 016509) |
| 2086S0120X Surgery Pediatric Surgery (Licence: TN 62296) | |
| 2086S0120X Surgery Pediatric Surgery (Licence: IN 01079883A) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2024-04-22 |