| NPI | 1063745388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301092120) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01076835A) |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2019-04-18 |