| NPI | 1659503316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A115525) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 76451) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2025-02-24 |