| NPI | 1083761019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01074216A) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301101564) |
| 208600000X Surgery (Licence: PA MT185869) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IN 01074216A) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2022-09-13 |