| NPI | 1134220882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 45490) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME 40657) |
| 2086S0129X Surgery, Vascular Surgery (Licence: UT 7004934-1205) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2017-03-10 |