| NPI | 1588079008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX S9818) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 6804) |
| 208600000X Surgery (Licence: TX S9818) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2023-07-21 |