| NPI | 1114365178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01076679A) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 11017292A) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2021-12-04 |