| NPI | 1013957695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MT 9598) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: MT 9598) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2023-11-27 |