| NPI | 1235157652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TN MD52126) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 105883) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MO 105883) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2022-03-29 |