| NPI | 1922035104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: ID M6776) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MS 29904) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2022-03-21 |