| NPI | 1700857869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2005-01045) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 200501045) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: NC 2005-01045) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2023-01-17 |