| NPI | 1679733927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A128212) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 236799) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2021-11-19 |