| NPI | 1235261181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: AR E-5267) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: TX L1647) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-10-02 |