| NPI | 1437458239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: AZ 56208) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: AZ R73891) |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2019-04-30 |