| NPI | 1851731103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MI 5101020705) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101020705) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2023-01-03 |