| NPI | 1902831779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WV 23694) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 23694) |
| 208600000X Surgery (Licence: WV 23694) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2022-10-31 |