| NPI | 1962405993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: IN 01040403A) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01040403A) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2014-03-31 |