| NPI | 1932314283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: GA 071205) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL 25628) |
| 2086S0129X Surgery Vascular Surgery (Licence: FL ME103944) | |
| 2086S0129X Surgery Vascular Surgery (Licence: CA A117666) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2022-01-10 |