| NPI | 1013912914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101055612) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101055612) |
| 2086S0129X Surgery Vascular Surgery (Licence: VA 0101055612) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2024-07-04 |