| NPI | 1841422094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WY 10758A) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101256665) |
| 2086S0129X Surgery, Vascular Surgery (Licence: WY 10758A) | |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2022-10-28 |