| NPI | 1215950035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 200201214) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: VA 0101235046) |
| 208600000X Surgery (Licence: VA 0101235046) | |
| 2086S0129X Surgery Vascular Surgery (Licence: NC 200201214) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2023-06-20 |