| NPI | 1578561528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: SC MD82195) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101221429) |
| 2086S0129X Surgery Vascular Surgery (Licence: NC 201800885) | |
| 2086S0129X Surgery Vascular Surgery (Licence: VA 0101221429) | |
| 2086S0129X Surgery Vascular Surgery (Licence: MA 76348) | |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2024-04-04 |