| NPI | 1336670819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: HI MD-24168-0) |
| Additional Taxonomies | 208600000X Surgery (Licence: HI MDR-####) |
| Enumeration Date | 2017-03-25 |
| Last Update Date | 2025-11-19 |