| NPI | 1649432337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CO 054269) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WI 55469-20) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2021-06-14 |