| NPI | 1447562640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 55078) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT191085) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301103519) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2021-07-22 |