| NPI | 1497724371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: IA 37241) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: GU MOO1472) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-06-14 |