| NPI | 1891998944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: SC 22767) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: MI 4301085246) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2024-01-12 |