| NPI | 1629438874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: HI 19352) |
| Additional Taxonomies | 208600000X Surgery (Licence: HI 19352) |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2024-08-13 |