| NPI | 1023000858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: DC 33799) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: SC 51943) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2018-04-06 |