| NPI | 1164684734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TN 69514) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WI 3048-320) |
| 2086S0129X Surgery, Vascular Surgery (Licence: WA MD60870970) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: CA A115211) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2024-09-26 |