| NPI | 1174814644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: NV 29281) |
| Additional Taxonomies | 2086S0129X (Licence: IL 036.166775) |
| 2086S0129X (Licence: IN 01087108A) | |
| 208600000X Surgery (Licence: IN 01087108A) | |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2026-06-18 |