| NPI | 1043535602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101253479) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AZ pending) |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2022-02-17 |