| NPI | 1811066608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: IN 01076035A) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: PA MD428834) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-12-23 |