| NPI | 1740840024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NC 202401260) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: SC LL82831) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2024-06-19 |