| NPI | 1699750752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NC 9601600) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 9601600) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NC 9601600) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2022-03-29 |