| NPI | 1558366443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: AR C5099) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AR C-5099) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2023-03-07 |