| NPI | 1376801548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: LA 333086) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MO 2017013106) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2023-10-26 |