| NPI | 1194737478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: MI 4301500422) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2005-01060) |
| 208600000X Surgery (Licence: IN 01035930A) | |
| 2086S0129X (Licence: NC 2005-01060) | |
| 2086S0129X (Licence: IN 01035930A) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2022-08-01 |