| NPI | 1518982800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 200400135) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NC 2004-00135) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2022-02-10 |