| NPI | 1730260803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: IN 01077484) |
| Additional Taxonomies | 208600000X Surgery (Licence: ME EC-05-100) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2022-03-25 |