| NPI | 1750354924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX K9991) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OK 44401) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2024-11-20 |