| NPI | 1437135373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MS 20979) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TN MD29549) |
| 2086S0129X Surgery, Vascular Surgery (Licence: GA 044417) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: WA MD00022869) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2014-12-03 |