| NPI | 1558011270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 74605) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MN 32479) |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2023-07-11 |