| NPI | 1598008724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 68582) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: SD 11157) |
| Enumeration Date | 2013-04-06 |
| Last Update Date | 2023-11-27 |