| NPI | 1316100860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WI 60794) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125051307) |
| 2086S0129X Surgery, Vascular Surgery (Licence: IL 125051307) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: IL 036.126901) | |
| Enumeration Date | 2008-07-04 |
| Last Update Date | 2013-10-03 |