| NPI | 1366892994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: OH 34C.000424) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: IN 02007201A) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2025-06-18 |