| NPI | 1437321411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 45776) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 77524) |
| 2086S0129X Surgery, Vascular Surgery (Licence: TN 64044) | |
| Enumeration Date | 2008-03-30 |
| Last Update Date | 2021-11-17 |