| NPI | 1093210262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 65817) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MN 29124) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2023-12-21 |