| NPI | 1992777338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL 125959) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MN 47964) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2020-10-14 |