| NPI | 1508932575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01084443A) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD 926124) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-12-29 |