| NPI | 1699296756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 71160) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101023622) |
| 208600000X Surgery (Licence: MI 5151013360) | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2024-08-26 |