| NPI | 1457766958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MI 4301506817) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301105689) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2022-09-08 |