| NPI | 1083662647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: OR MD178103) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR MD178103) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2016-10-12 |