| NPI | 1700856275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MI BS057856) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: KY C1904) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2024-04-03 |