| NPI | 1881675882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MT MED-PHYS-LIC-95941) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TN 41520) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2021-11-10 |