| NPI | 1174773873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX Q5072) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2008018810) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MS 28194) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: MO 2010018439) | |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2024-05-29 |