| NPI | 1639330053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME164624) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX M7050) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2023-11-27 |