| NPI | 1619946407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036158719) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: IN 01061651A) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: NM MD2018-0046) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35078129) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: CO DR.0057836) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036158719) | |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2022-12-20 |