| NPI | 1962496653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CA G65955) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA G65955) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2015-07-10 |