| NPI | 1669404265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: KY 37361) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IN 01043847A) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2018-04-20 |