| NPI | 1629037445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NC 200101263) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 200101263) |
| 174400000X Specialist (Licence: NC 200101263) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2023-12-18 |