| NPI | 1316035942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 6885624-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G79243) |
| 2086S0129X Surgery, Vascular Surgery (Licence: CA G79243) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: UT 6885624-1205) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2012-08-02 |