| NPI | 1447699947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: GA 92870) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: SC 87399) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2024-03-12 |