| NPI | 1720041767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 200300327) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: NC 200300327) |
| 2086S0129X Surgery Vascular Surgery (Licence: NC 200300327) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2019-12-03 |