| NPI | 1457316234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101283518) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: FL 0076238) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2024-09-11 |