| NPI | 1992859102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: HI DOS-1555) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 60 240073) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2022-11-28 |