| NPI | 1225068471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: SC 40142) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: GA 057698) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2016-09-29 |