| NPI | 1033648985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 71187) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 71187) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2024-04-27 |