| NPI | 1164612453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: IA 40725) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT 181967) |
| 208600000X Surgery (Licence: MI 4301106309) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: IL 036125531) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301106309) | |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2023-11-27 |