| NPI | 1942362942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: KY 55903) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: GA 043160) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2022-06-16 |