| NPI | 1962511212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MS 19031) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MS 19031) |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: MS 19031) | |
| 2086S0129X Surgery Vascular Surgery (Licence: MS 19031) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-04-27 |