| NPI | 1528326667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: GA 078538) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: SC 51428) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2022-09-13 |