| NPI | 1558576041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AR E-6234) |
| Additional Taxonomies | 208600000X Surgery (Licence: AR e-6234) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MO 2017033725) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2021-12-27 |