| NPI | 1841255932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: SD 14037) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 51100) |
| 2086S0129X Surgery, Vascular Surgery (Licence: KY TP952) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: KY 55554) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: MN 51100) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2023-07-07 |