| NPI | 1245626282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2021014858) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MO 2021014858) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2023-03-06 |