| NPI | 1700806668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX U9625) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01060533a) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: HI MD-19723) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2024-07-29 |