| NPI | 1962791632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WI 60926-20) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OR MD174080) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2017-11-20 |