| NPI | 1548558612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: AR E10076) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 02007472A) |
| 208600000X Surgery (Licence: FL UO3383) | |
| 208600000X Surgery (Licence: FL OS14245) | |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2025-07-12 |