| NPI | 1093729121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA G39110) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G39110) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA G39110) | |
| 207X00000X Orthopaedic Surgery (Licence: CA G39110) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-05-28 |