| NPI | 1427134659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: NE 18485) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: KS 04-26749) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2012-02-01 |