| NPI | 1275862716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WI 4-876) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WI 216-875) |
| Enumeration Date | 2009-12-11 |
| Last Update Date | 2021-02-02 |