| NPI | 1518255801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AR E-16880) |
| Additional Taxonomies | 208600000X Surgery (Licence: AR E-16880) |
| 208600000X Surgery (Licence: PA MT199572) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: NY 295714) | |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2023-08-25 |