| NPI | 1598726960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: ID M-10811) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD431690) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NH 11102) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2022-04-25 |