| NPI | 1811300817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: IN 01091291A) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA R-10033) |
| 208600000X Surgery (Licence: KY 52660) | |
| 208600000X Surgery (Licence: IN 01091291A) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: KY 52660) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: MI 4301505625) | |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2023-10-10 |