| NPI | 1942321799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 84915) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 63379) |
| 208600000X Surgery (Licence: IN 01073856A) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2021-03-10 |