| NPI | 1700012598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AK MEDS8033) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MA 240421) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2022-07-12 |