| NPI | 1629296876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 62971) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CT 049839) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2018-03-17 |