| NPI | 1073619870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX L7667) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: GA G055100) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2007-07-08 |