| NPI | 1104874569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WA MD00048859) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IN 1050911A) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-06-23 |