| NPI | 1609075860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX M7116) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX M7116) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2023-02-15 |