| NPI | 1427300615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01078750A) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57.021531) |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2020-11-05 |