| NPI | 1427020403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101051511) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 59179) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2020-09-24 |