| NPI | 1033107305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101041155) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: DC 15629) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2021-08-24 |