| NPI | 1770145401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301512530) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MO 2019021935) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2024-08-16 |