| NPI | 1649278599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 67209) |
| Additional Taxonomies | 202K00000X (Licence: AZ 67209) |
| 208600000X Surgery (Licence: CA G86289) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: CO DR.0059259) | |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2025-02-15 |