| NPI | 1295907277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: KY 48637) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NC 2013-00994) |
| Enumeration Date | 2008-03-30 |
| Last Update Date | 2015-10-08 |