| NPI | 1750698635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A122213) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01071449A) |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2023-01-12 |