| NPI | 1053431841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301083695) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MO 2013023329) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2019-10-29 |