| NPI | 1730180530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01044092A) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35075385M) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2020-11-05 |