| NPI | 1972982239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A149972) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A149742) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2023-04-20 |