| NPI | 1326073719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: LA MD.015860) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 15860) |
| 2086S0129X Surgery, Vascular Surgery (Licence: LA MD.015860) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2021-10-21 |