| NPI | 1417993247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA G88336) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MA 70733) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2018-10-10 |