| NPI | 1629047584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: VA 0101044778) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101044778) |
| 208600000X Surgery (Licence: VA 0101044778) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2021-08-23 |