| NPI | 1386683613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD055401L) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01064871A) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2023-10-30 |