| NPI | 1013020411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA G019871) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD428117) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2007-07-08 |