| NPI | 1093725707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 38302) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX 40792) |
| 2086S0129X Surgery, Vascular Surgery (Licence: PA MD455889) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2021-02-02 |