| NPI | 1396022489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01078725A) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301099040) |
| 208600000X Surgery (Licence: NC 2016-01266) | |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2022-10-10 |