| NPI | 1073714358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: LA 201525) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CT 044485) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2023-03-07 |