| NPI | 1104894930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: PA MD019220E) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD019220E) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2011-10-19 |