| NPI | 1255305744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: NE 13355) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 13355) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2011-01-27 |