| NPI | 1750768388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 71045) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 52930) |
| 2086S0129X Surgery, Vascular Surgery (Licence: AZ 52930) | |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2022-08-29 |