| NPI | 1386646636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MI 5101009861) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 5101009861) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2010-12-07 |