| NPI | 1912967712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NC 29966) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 29966) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2023-06-15 |