| NPI | 1952711665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: KY TP992) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125-065649) |
| 208600000X Surgery (Licence: IL 036.153047) | |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2022-08-19 |