| NPI | 1285796383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: ID M-12611) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: GA 038288) |
| 208600000X Surgery (Licence: GA 038288) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2023-05-23 |