| NPI | 1326022039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TN 36524) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MA 205177) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2024-03-06 |