| NPI | 1619965928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME61608) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME61608) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2022-05-27 |