| NPI | 1154504082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: GA 70309) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MN 54147) |
| 208600000X Surgery (Licence: MI 4301086626) | |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2021-04-27 |