| NPI | 1053533349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: KS 04-31478) |
| Additional Taxonomies | 208600000X Surgery (Licence: KS 0431478) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2021-08-02 |