| NPI | 1437159399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 33416) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: WI 33416) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2008-03-18 |