| NPI | 1235252032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: GA 95820) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 95820) |
| 208600000X Surgery (Licence: MI 4301103260) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301103260) | |
| Enumeration Date | 2007-04-08 |
| Last Update Date | 2023-08-15 |