| NPI | 1417928474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NC 2018-00327) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NH 12060) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2021-06-02 |