| NPI | 1528062338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MO R8N86) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO R8N86) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2021-11-22 |