| NPI | 1396720470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME106828) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 40743) |
| 208600000X Surgery (Licence: FL ME106828) | |
| 208600000X Surgery (Licence: GA 055964) | |
| Enumeration Date | 2005-12-12 |
| Last Update Date | 2022-02-09 |