| NPI | 1871677658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0068656) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 31917) |
| 208600000X Surgery (Licence: AR E1254) | |
| 208600000X Surgery (Licence: AR E-1254) | |
| 208600000X Surgery (Licence: SC 16865) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2022-07-12 |