| NPI | 1275621823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CA A36413) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A36413) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2012-10-23 |