| NPI | 1609980499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 33686) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CT 046924) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2019-03-14 |