NPI | 1851550057 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: TX Q8952) |
Additional Taxonomies | 208600000X Surgery (Licence: TX Q8952) |
2086S0120X Surgery, Pediatric Surgery (Licence: TN 50691) | |
2086S0120X Surgery, Pediatric Surgery (Licence: OK 37335) | |
Enumeration Date | 2008-06-03 |
Last Update Date | 2023-07-21 |