| NPI | 1093716938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CT 015495) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CT 015495) |
| 208600000X Surgery (Licence: CT 015495) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2007-07-08 |