| NPI | 1104824788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 039210) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: CT 039210) |
| 2086S0129X Surgery, Vascular Surgery (Licence: CT 039210) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2010-03-31 |