| NPI | 1982739058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: DC MD045875) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: IN 01078069A) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: CA A109447) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2023-01-12 |