| NPI | 1912900283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AL MD19175) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AL 00019175) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2021-01-04 |