| NPI | 1326001611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 20538) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: NC 20538) |
| 2086X0206X Surgery Surgical Oncology (Licence: NC 20538) | |
| Enumeration Date | 2006-04-09 |
| Last Update Date | 2007-07-08 |