| NPI | 1194705806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: WI 13787) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: IN 01043357A) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2025-10-27 |