| NPI | 1730219205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: SC 23612) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: NC 200600766) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2022-11-03 |