| NPI | 1578763926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA a103795) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY TP119) |
| 2086S0129X Surgery, Vascular Surgery (Licence: KY TP119) | |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2021-11-29 |