| NPI | 1851633754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 69448-20) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WI 69448-20) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2022-05-24 |