| NPI | 1720039803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 13149947-1205) |
| Additional Taxonomies | 174400000X Specialist (Licence: IN 01061857A) |
| 208600000X Surgery (Licence: IL 036103523) | |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2023-06-13 |