| NPI | 1407031347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: GA 054334) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 054334) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2020-10-15 |