| NPI | 1770588345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: KS 04-20714) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO R1E83) |
| 174400000X Specialist (Licence: KS 04-20714) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2010-07-24 |