| NPI | 1932441623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036154025) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: PA TMD005061) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: VA 0101285473) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2025-09-04 |