| NPI | 1396820809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: KY 39066) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: IN 01088639A) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2023-03-21 |