| NPI | 1790784676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 32039) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01046315A) |
| 2086S0129X Surgery, Vascular Surgery (Licence: IN 01046315A) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: KY 32039) | |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2023-11-27 |