| NPI | 1275971772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: HI MD-18188) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: HI MD-18188) |
| 208600000X Surgery (Licence: HI MD-18188) | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2023-08-21 |