| NPI | 1902089345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NC 2009-00948) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 121855) |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2020-10-25 |