| NPI | 1679549356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01087941A) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036111304) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2026-05-06 |