| NPI | 1750430617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: ID M-5421) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036.155262) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036.155262) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2024-07-09 |