| NPI | 1962692194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CO DR.0052910) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WI 65436) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2018-10-10 |