| NPI | 1225038334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 37389) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01056579A) |
| 2086S0129X (Licence: KY 37389) | |
| 2086S0129X (Licence: IN 01056579A) | |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2024-11-02 |