| NPI | 1457383366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CA A71886) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: ND 22037) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2025-05-22 |