| NPI | 1780983460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: NJ 25MA10836300) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: NY 303998) |
| 208600000X Surgery (Licence: VA 0101282161) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: VA 0101282161) | |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2024-07-18 |