| NPI | 1386732915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: CA GO82239) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CA GO82239) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2018-03-17 |