| NPI | 1427213636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WV 22654) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 22654) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2008-09-20 |