| NPI | 1013929439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME106124) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI RQ075615) |
| 2086S0129X Surgery Vascular Surgery (Licence: FL ME106124) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2020-04-15 |