| NPI | 1427140037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MI 4301039466) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: OH 35.046207) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2007-07-08 |