| NPI | 1316298367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: NV 20561) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 56464) |
| 208600000X Surgery (Licence: NV 20561) | |
| 2086S0129X Surgery Vascular Surgery (Licence: AZ 56464) | |
| 2086X0206X Surgery Surgical Oncology (Licence: NV 20561) | |
| Enumeration Date | 2012-09-29 |
| Last Update Date | 2023-08-15 |