| NPI | 1932165479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: PA MD060010L) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD060010L) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2022-03-10 |