| NPI | 1720189640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A41720) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: HI MD-8790) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2019-04-03 |