| NPI | 1447412929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ID M-12152) |
| Additional Taxonomies | 208600000X Surgery (Licence: ND RL10648) |
| 208600000X Surgery (Licence: ND 12284) | |
| 208600000X Surgery (Licence: OR MD165259) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2017-03-08 |