| NPI | 1184734402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01045065A) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME133717) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-05-18 |