| NPI | 1104880160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101046591) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MT 51819) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2022-10-04 |