| NPI | 1952639866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: NJ 25MA10497700) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: NY 255457) |
| Enumeration Date | 2009-12-04 |
| Last Update Date | 2021-07-23 |