| NPI | 1700095916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: VA 0101258375) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101258375) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116018532) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: RI clp02714) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2022-05-24 |