| NPI | 1770791378 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: IN 01074108A) | 
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01074108A) | 
| Enumeration Date | 2007-05-18 | 
| Last Update Date | 2021-10-14 |