| NPI | 1861855017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CO DR.0066047) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WI 68790) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2022-03-14 |