| NPI | 1538121140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CA C128878) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: TX M1831) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: CA A128878) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2023-05-10 |