| NPI | 1548460553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01085119A) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 2733599) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2022-12-28 |