NPI | 1700902608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: KS 04-23862) |
Additional Taxonomies | 208600000X Surgery (Licence: NM 20030056) |
208600000X Surgery (Licence: IL 036131963) | |
Enumeration Date | 2007-03-22 |
Last Update Date | 2016-11-22 |