| NPI | 1528352754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: TN 70846) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT199421) |
| 208600000X Surgery (Licence: TN 70846) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2024-11-04 |