| NPI | 1912914714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NC 2012-00441) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IN 01067280A) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2012-04-30 |