| NPI | 1730111725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: KY 28037) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IN 01046961) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2024-03-01 |