| NPI | 1407014657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: AR E-19486) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 11013873A) |
| 2086S0129X (Licence: IN 01067593A) | |
| 2086S0129X (Licence: OH 35.127926) | |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2025-08-20 |