| NPI | 1750324794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301049437) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301049437) |
| 208600000X Surgery (Licence: MI 4301049437) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2018-08-16 |