| NPI | 1992029904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: LA MD.205510) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: SC 40595) |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2023-02-01 |