| NPI | 1982825204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 57198) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NH RT 1693) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-13 |