NPI | 1992871412 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MA 270597) |
Additional Taxonomies | 208600000X Surgery (Licence: FL 511220) |
208600000X Surgery (Licence: MA 270597) | |
Enumeration Date | 2006-11-27 |
Last Update Date | 2019-06-17 |