| NPI | 1588664932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: IN 01078636A) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: MI 057466) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2018-04-23 |