| NPI | 1356492474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NH 17558) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 241680) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NH 17558) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2019-10-02 |