| NPI | 1598756595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: ND 15311) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: WV 22434) |
| 208600000X Surgery (Licence: NM 20030588) | |
| 2086S0129X Surgery Vascular Surgery (Licence: WV 22434) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2023-04-13 |