| NPI | 1295178697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: SC 61157) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL 34061) |
| 2086S0129X Surgery, Vascular Surgery (Licence: AL 34061) | |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2022-07-25 |