| NPI | 1982751004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CA G31166) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G31166) |
| 208600000X Surgery (Licence: CA G31166) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CA G31166) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: CA g31166) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2024-04-29 |