| NPI | 1124284427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TN 47345) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301101987) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2023-02-10 |