| NPI | 1407902034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OR MD209520) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM MD2014-0708) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NM MD2014-0708) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: CO DR.0050981) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2023-06-20 |