| NPI | 1639684434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 71808) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 71808) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MD D48430) | |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2022-10-10 |