| NPI | 1376778274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 61692) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA L-240525) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MA 261471) | |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2020-08-20 |