| NPI | 1972750289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: PA MD045047L) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: MT 0001893) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: NJ 25MA10685300) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MI 4301095218) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: IN 01082101A) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MS 22683) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35.126281) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MO 2020040870) | |
| 208600000X Surgery (Licence: NY 248869) | |
| 208600000X Surgery (Licence: MI 4301095218) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301095218) | |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2023-06-29 |