| NPI | 1154355311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: ND 12238) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CA A64977) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MN 51249) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2012-09-21 |