| NPI | 1366486938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CA A108740) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 218729) |
| 2086S0129X Surgery Vascular Surgery (Licence: MA 218729) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2009-07-24 |