| NPI | 1588683585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN MD19962) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN MD19962) |
| 2086S0129X Surgery, Vascular Surgery (Licence: TN MD19962) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2015-03-10 |