| NPI | 1649382227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WV 20329) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101237879) |
| 2086S0129X Surgery, Vascular Surgery (Licence: WV 20329) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-09-25 |