| NPI | 1417088808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101034868) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NC 201001298) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2017-11-15 |