NPI | 1932117462 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CA G83234) |
Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: OR MD23219) |
Enumeration Date | 2006-08-03 |
Last Update Date | 2021-03-23 |