| NPI | 1235336793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01072432A) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT190491) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2023-09-15 |