| NPI | 1053385724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: GA 069215) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 48282) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MN 48282) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2020-10-28 |