| NPI | 1144415290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WV 23745) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: KY 49476) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2021-07-01 |