| NPI | 1710909163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: LA MD.023569) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA 023569) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: LA 023569) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2021-06-18 |