| NPI | 1497961155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2013-00133) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AL L2735) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NC 2013-00133) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-04-17 |