| NPI | 1346239571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01068850A) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 234562) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2012-04-05 |