| NPI | 1649306853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101251780) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101251780) |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2024-06-11 |