| NPI | 1548232879 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: IN 01068359A) | 
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: VA 0101-048041) | 
| Enumeration Date | 2006-02-02 | 
| Last Update Date | 2015-04-08 |