| NPI | 1487676045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AL 00025324) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AL MD.25324) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2022-11-03 |