| NPI | 1790726982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: NY 250182) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: NY 0024381) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2012-01-19 |