| NPI | 1467403352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AR E-0113) |
| Additional Taxonomies | 208600000X Surgery (Licence: WY 11503A) |
| 208600000X Surgery (Licence: TN MD31513) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2025-11-14 |