NPI | 1891776191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MD D86445) |
Additional Taxonomies | 208600000X Surgery (Licence: MA 217767) |
208600000X Surgery (Licence: MI 4301092951) | |
2086S0120X Surgery, Pediatric Surgery (Licence: MI 4301092951) | |
Enumeration Date | 2005-11-14 |
Last Update Date | 2019-01-04 |