| NPI | 1396766242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AL 16115) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: AL 16115) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2024-05-27 |