| NPI | 1083884100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MA 1020537) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CT 046254) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2024-10-31 |