| NPI | 1902009517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01069298A) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD417200) |
| Enumeration Date | 2007-06-10 |
| Last Update Date | 2021-02-19 |