| NPI | 1457505810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: TN MD0000047757) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 47757) |
| 2086S0129X Surgery Vascular Surgery (Licence: MA 281983) | |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2023-04-04 |