| NPI | 1326305830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: IA MD-45213) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: IA R-9657) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2018-08-22 |