NPI | 1861631244 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CO 47536) |
Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: NM MD2017-0793) |
Enumeration Date | 2009-02-09 |
Last Update Date | 2019-12-10 |