| NPI | 1689802977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: WI 65518-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 65518-20) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2019-12-12 |