| NPI | 1083859649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CT 046129) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CT 046129) |
| 208600000X Surgery (Licence: CT 046129) | |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2011-03-29 |