| NPI | 1598759771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101052249) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101052249) |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2016-06-16 |