| NPI | 1205078912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OK 30546) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CO 0061725) |
| Enumeration Date | 2009-03-26 |
| Last Update Date | 2019-04-04 |