| NPI | 1114018199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CA G22975) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: CA G229750) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2013-02-28 |