| NPI | 1851612592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: TX Q5326) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: MA 245521) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2023-04-14 |