NPI | 1881613370 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MA 79559) |
Additional Taxonomies | 208600000X Surgery (Licence: MA 79559) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2014-03-21 |