| NPI | 1316386303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: SC 36016) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2018-01795) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NC 2018-01795) | |
| Enumeration Date | 2013-06-23 |
| Last Update Date | 2021-11-03 |