| NPI | 1770529240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 31856) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: ID M-12006) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2021-08-23 |