| NPI | 1316967045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01066565A) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR MD25437) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2016-02-09 |