| NPI | 1184610453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL OS9545) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0102202423) |
| 2086S0129X Surgery, Vascular Surgery (Licence: VA 0102202423) | |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2020-04-15 |