| NPI | 1013923481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A91766) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A91766) |
| 208600000X Surgery (Licence: CA A91766) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2011-06-02 |