| NPI | 1285694141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WI 42511) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MN 51703) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2023-04-27 |