| NPI | 1275613093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: AZ 72446) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: CA G49895) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2025-01-15 |