| NPI | 1427267822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101241789) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: GA 062462) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2011-08-02 |