| NPI | 1366754616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NH 21850) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO DR.0071931) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IN 01080960A) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2024-01-04 |