| NPI | 1366435182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: GA 052556) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 54489) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2024-01-24 |