| NPI | 1639558745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: HI MD-23602) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A144084) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2023-08-10 |