| NPI | 1639484603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: HI MD19190) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: HI MD19190) |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2020-06-16 |