| NPI | 1831318195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 52998) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: GA 64257) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2017-04-08 |