| NPI | 1992769145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: TN 63115) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: MA 81237) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2022-03-18 |