| NPI | 1902898182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: LA 12605) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 41244 020) |
| 2086S0127X Surgery, Trauma Surgery (Licence: GA 42169) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2023-07-19 |