| NPI | 1598782088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01062091A) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM MD2010-0754) |
| 208600000X Surgery (Licence: VT 042-0012180) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-05-18 |