| NPI | 1831171107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: AZ 31590) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: OR MD155068) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2014-02-04 |