| NPI | 1811144181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: GA 061656) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 061656) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2022-12-20 |