| NPI | 1356341648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 028962) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CT 028962) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2010-06-30 |