| NPI | 1306842570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AL DO208) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL DO208) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: AL DO208) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2018-03-17 |