| NPI | 1114989407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD D73364) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01053450A) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2018-03-17 |