| NPI | 1801102439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: MI 5101027189) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 02006362A) |
| 208D00000X General Practice (Licence: VA 0102202893) | |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2023-06-16 |