| NPI | 1174676829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: GA 037025) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: SC 93014) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2024-10-02 |