| NPI | 1215982467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 247458) |
| Additional Taxonomies | 174400000X Specialist (Licence: IN 1058276A) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2011-06-16 |