| NPI | 1588656243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CO DR.0069784) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: KS 04-35274) |
| 2086S0129X Surgery Vascular Surgery (Licence: MO 2011004796) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2023-11-28 |