| NPI | 1013909449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CT 022033) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CT 022033) |
| 208600000X Surgery (Licence: CT 022033) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2011-03-21 |