| NPI | 1356304075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 63401) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TN MD52234) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2018-03-29 |