| NPI | 1215343553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TN 63733) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301095037) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2021-08-18 |