| NPI | 1780261495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 71906) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MN 31607) |
| Enumeration Date | 2021-03-27 |
| Last Update Date | 2022-08-09 |