| NPI | 1972712388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MD D73008) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301088968) |
| 2086S0129X Surgery, Vascular Surgery (Licence: PA TMD004748) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-09-16 |