| NPI | 1700237187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IN 02006435A) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.069371) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2021-07-22 |