| NPI | 1538123534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: LA 1256R) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MS 27948) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2020-10-20 |