| NPI | 1386969137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MS 28756) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101251335) |
| 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101251335) | |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2024-01-15 |