| NPI | 1982868766 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IN 01078358A)  | 
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01078358A)  | 
| Enumeration Date | 2008-07-11 | 
| Last Update Date | 2021-11-16 |