| NPI | 1336179027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G28654) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CA G28654) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2007-07-08 |