| NPI | 1669673216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01073821A) |
| Additional Taxonomies | 208600000X Surgery (Licence: ME td121120) |
| 208600000X Surgery (Licence: PA MD447654) | |
| 208600000X Surgery (Licence: MI 4301089619) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2022-02-24 |