| NPI | 1790861532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME78612) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME0078612) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2024-01-11 |