| NPI | 1346467420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MO 2017017630) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TN MD51723) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2022-07-21 |