| NPI | 1700294311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME165034) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MN 59496) |
| 2086S0129X Surgery, Vascular Surgery (Licence: TX T4223) | |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2024-01-12 |