| NPI | 1245274851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OR MD189626) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WA 60404648) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2018-09-24 |