| NPI | 1497802151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01068577A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IL 36116452) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2025-09-30 |