NPI | 1700849924 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CO DR-45824) |
Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: NM MD2017-0880) |
2086S0120X Surgery, Pediatric Surgery (Licence: CO 45824) | |
Enumeration Date | 2006-04-10 |
Last Update Date | 2019-12-20 |