| NPI | 1285691170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 83831) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD466974) |
| 208600000X Surgery (Licence: IN 01052812A) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2020-08-03 |