| NPI | 1124012109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: HI 16287) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: TN MD16542) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2024-01-16 |