| NPI | 1063498855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IA 26048) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IA MD-26048) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2023-04-25 |