| NPI | 1356300834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME137749) |
| Additional Taxonomies | 202K00000X (Licence: FL ME137749) |
| 202K00000X (Licence: IN 01041607A) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: FL ME137749) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: IN 01041607A) | |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2023-03-13 |