| NPI | 1497168314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 02006533A) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5151012927) |
| 208600000X Surgery (Licence: IL 036150381) | |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2023-05-01 |