| NPI | 1982691531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MS 21897) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01056020A) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2018-10-15 |