| NPI | 1427463116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PR 31405) |
| Additional Taxonomies | 208600000X Surgery (Licence: PR 31405) |
| Enumeration Date | 2014-06-22 |
| Last Update Date | 2022-11-15 |