| NPI | 1821098302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MS 29684) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 010123820) |
| 208600000X Surgery (Licence: WV 19959) | |
| 2086S0129X Surgery Vascular Surgery (Licence: WV 19959) | |
| 2086S0129X Surgery Vascular Surgery (Licence: VA 0101-238200) | |
| 2086S0129X Surgery Vascular Surgery (Licence: GA 77788) | |
| 2086S0129X Surgery Vascular Surgery (Licence: VA 0101238200) | |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2022-04-29 |