| NPI | 1114289774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 66443) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TN 59339) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2022-06-21 |