| NPI | 1083687859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MO 2020018872) |
| Additional Taxonomies | 202K00000X (Licence: MO 2020018872) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2024-09-16 |