| NPI | 1184829558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: HI 15826) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IA 37906) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2010-08-26 |