| NPI | 1740281674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01050466A) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35076656M) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2020-11-05 |