| NPI | 1932313095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101241535) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101241535) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2022-08-05 |