| NPI | 1184156465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: FL ME165442) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME165442) |
| 208600000X Surgery (Licence: VA 0101278676) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: IL 036.166207) | |
| 2086S0127X Surgery Trauma Surgery (Licence: WI 84274-20) | |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2025-04-23 |