| NPI | 1871750695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101267038) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NC 2011-00302) |
| 208600000X Surgery (Licence: NC 2011-00302) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2022-11-18 |