| NPI | 1679100937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 69746) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MN 30890) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2021-07-27 |