| NPI | 1851587398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NC 2017-00692) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD430426) |
| 208600000X Surgery (Licence: CA A120818) | |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2022-07-21 |