| NPI | 1699803940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: GA 056690) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: GA 056690) |
| 208600000X Surgery (Licence: GA 056690) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2016-06-13 |