| NPI | 1306112487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: TN 57890) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: MS 28172) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2023-06-08 |