| NPI | 1881670669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN MD017710) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TN MD017710) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2020-07-14 |