| NPI | 1346680782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AL MD.40425) |
| Additional Taxonomies | 208600000X Surgery (Licence: MS T-2717) |
| Enumeration Date | 2013-06-30 |
| Last Update Date | 2020-06-16 |