| NPI | 1760487151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IA 25567) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: IA 25567) |
| 2086S0129X Surgery Vascular Surgery (Licence: IA 25567) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2021-03-04 |