| NPI | 1265619365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME113143) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 002604) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2024-09-08 |