| NPI | 1285945824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CO DR.0065280) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: WI 67222-20) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2021-02-12 |