| NPI | 1730228099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL OS18234) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA OS-001972-L) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2024-01-16 |