| NPI | 1801891189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: IN 01048422A) |
| Additional Taxonomies | 2086S0129X (Licence: OH 35.090263) |
| 208600000X Surgery (Licence: IN 01048422A) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2016-09-14 |