| NPI | 1770625832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: GA 056520) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: GA 056520) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2019-05-28 |