| NPI | 1952622797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: IN 01071014A) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2023-01-05 |