| NPI | 1740222322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CO 44420) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CO 0044420) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2022-07-28 |