| NPI | 1679567325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WV 12612) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101057487) |
| 2086S0129X Surgery, Vascular Surgery (Licence: IN 01066693A) | |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2013-11-22 |