| NPI | 1316140882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 02003347A) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101015915) |
| 208600000X Surgery (Licence: FL OS10124) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2011-04-25 |