| NPI | 1538541958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN 63544) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2015018128) |
| 208600000X Surgery (Licence: ND RL14191) | |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2021-07-19 |