| NPI | 1316016397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NC 2013-01204) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2013-01240) |
| 208600000X Surgery (Licence: FL TRN10139) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2024-03-12 |