| NPI | 1346421856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101250786) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WV 29811) |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2023-06-08 |