| NPI | 1063484061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 44841) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MN 44841) |
| 2086S0129X Surgery, Vascular Surgery (Licence: SD 5847) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: SD 5847) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2011-11-14 |