| NPI | 1144492943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: UT 9423472-1205) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: ID MC-1347) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2023-03-07 |