| NPI | 1780685347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: WV 23938) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35078804) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX E6372) | |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2022-04-07 |