| 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) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2021-04-02 |