| NPI | 1215299524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 297341) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01078511A) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2023-05-10 |