NPI | 1649290321 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: AR E-18184) |
Additional Taxonomies | 208600000X Surgery (Licence: NC 2023-02730) |
208600000X Surgery (Licence: AR E-18184) | |
2086S0120X Surgery, Pediatric Surgery (Licence: OH 35-080742) | |
Enumeration Date | 2006-07-19 |
Last Update Date | 2024-09-05 |