| NPI | 1992758080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: TN MD40078) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD40078) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2018-07-05 |