| NPI | 1184113201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: KY 58505) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: KY TP808) |
| 2086S0129X Surgery Vascular Surgery (Licence: IN 01091477A) | |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2024-01-24 |