| NPI | 1114174125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: SC 35710) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: DE C1-0010094) |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2016-09-05 |