| NPI | 1912297557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MS 31345) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: GA 080579) |
| Enumeration Date | 2011-04-16 |
| Last Update Date | 2024-06-03 |