| NPI | 1033597232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: ID M-16436) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: WV 29421) |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2022-05-27 |