| NPI | 1316978299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA g45367) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G45367) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2015-06-02 |