| NPI | 1396829925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 04032) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 02004102A) |
| 208600000X Surgery (Licence: TN 1876) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2016-10-19 |