| NPI | 1528144235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 66894-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 79276) |
| 2086S0129X Surgery, Vascular Surgery (Licence: WI 66894-20) | |
| 208600000X Surgery (Licence: IL 036-142234) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: IL 036-142234) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2017-02-20 |