| NPI | 1053481531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ID M-6494) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: UT 328720-1205) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2008-04-17 |