| NPI | 1366605271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: KY 40942) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 40942) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2023-06-02 |