| NPI | 1306957246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101056988) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MD D68760) |
| 2086S0129X Surgery, Vascular Surgery (Licence: DC MD038935) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2021-06-14 |