| NPI | 1700891223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: ID M-16279) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OR MD17953) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2024-04-26 |