| NPI | 1962466748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AR R-2139) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AR R2139) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX K8415) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2018-03-17 |