| NPI | 1255337770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME54280) |
| Additional Taxonomies | 208600000X Surgery (Licence: MT 114789) |
| 208600000X Surgery (Licence: MS 20423) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: FL ME54280) | |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2023-10-23 |