| NPI | 1962723809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101273175) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC 39516) |
| 2086S0129X Surgery, Vascular Surgery (Licence: SC 39516) | |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2025-02-27 |