| NPI | 1639130453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: GA 033720) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: GA 33720) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2024-03-06 |