| NPI | 1821526906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: IA MD-46861) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA MD-46861) |
| 208600000X Surgery (Licence: TX BP10060957) | |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2020-06-16 |