| NPI | 1033177530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: SC 23559) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 23559) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-11-06 |