| NPI | 1255563334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A116141) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A116141) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2024-03-06 |