| NPI | 1053311621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 29587) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: IN 01046162) |
| 208600000X Surgery (Licence: IN 01046162) | |
| 2086S0129X Surgery Vascular Surgery (Licence: KY 29587) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2019-05-14 |