| NPI | 1447679782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101266875) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NC 2022-00863) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2022-05-26 |