NPI | 1689672172 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: LA MD.021642) |
Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: LA 021642) |
Enumeration Date | 2005-07-08 |
Last Update Date | 2013-06-26 |