| NPI | 1942495775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CT 048540) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A88743) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2023-06-13 |