| NPI | 1033181326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA C52420) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101224453) |
| 208600000X Surgery (Licence: IN 01051897A) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2017-10-19 |