| NPI | 1982125076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL OS20586) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2017018675) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2024-03-14 |