| NPI | 1942697313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IN 02006776A) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101021522) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2022-09-08 |