| NPI | 1184619892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A82215) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MT 10860) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2013-06-19 |