| NPI | 1861466708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX S9030) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01060735A) |
| 208600000X Surgery (Licence: OR MD165024) | |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2023-11-01 |