| NPI | 1962430504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AR E-4316) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AR E-4316) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2025-05-30 |